[Study of concurrent reconstruction of posterior wall of vagina with pedicled muscular flap of uterus after resection of rectum carcinoma].

OBJECTIVE: To investigate the reconstructional method of posterior wall of vagina after the resection of rectum carcinoma. METHODS: From August 1991 to March 1996, 10 patients with rectum carcinoma were adopted in this study, among them, there were 4 cases belong to B stage of Dukas, and 6 cases belong to C stage of Dukes. In operation, rectum carcinoma and posterior wall of vagina were resected, and concurrent reconstruction was finished by using pedicled muscular flap of uterus. RESULTS: The effect of operation were satisfactory except one case who was failed because of insufficient blood supply of the flap. Followed-up for 3-6 months, the posterior wall of vagina healed in 7 cases, the width of vagina was 2-3 fingers and the depth was 5-6 cm. CONCLUSION: Reconstruction of the posterior wall of vagina with pedicled muscular flap of uterus was available in clinic. For its simplicity and feasibility, it's suitable for the resection of rectum carcinoma in which the posterior wall of vagina was infiltrated.

[Rectal examination for extent of perirectal infiltration in rectal carcinoma].

From 1983 to 1985, 214 patients with rectal carcinoma were assessed for the conformation rate of the rectal examination to the gross findings of the extent of perirectal infiltration in the resected specimens. It was found that the conventional classification of the extent of rectal infiltration by rectal examination, 1/4, 1/3, 2/4, 3/4 and 4/4 of the circumference, had only a conformation rate of 32.7% to the gross findings. According to the classification of 1/4 or less and more, the conformation rate could reach 93%. It was also found that the extent of perirectal infiltration, being closely related to the regional lymph node metastasis and the depth of invasion, was only demonstrated by this latter classification, which was not shown in the conventional classification. Hence, it is suggested that the rectal examination implying the extent of perirectal infiltration by simply classified into two groups: equal to or less than 1/4 and more than 1/4 of the circumference of the rectal wall.